﻿<div class="blade-static __bottom" ng-include="'$(Platform)/Scripts/common/templates/ok-cancel2.tpl.html'"></div>
<div class="blade-content">
    <div class="blade-inner">
        <div class="inner-block">
            <form class="form" name="detailForm">
                <div class="form-group" ng-init="setForm(detailForm)">
                    <label class="form-label">Country</label>
                    <div class="form-input">
                        <ui-select ng-model="blade.currentEntity.countryCode" required>
                            <ui-select-match placeholder="Select ...">{{$select.selected.name}}</ui-select-match>
                            <ui-select-choices repeat="x.code as x in countries | filter: $select.search ">
                                <span ng-bind-html="x.name | highlight: $select.search"></span>
                            </ui-select-choices>
                        </ui-select>
                    </div>
                </div>
                <div class="form-group">
                    <label class="form-label">Region</label>
                    <div class="form-input">
                        <input ng-model="blade.currentEntity.stateProvince" placeholder="Enter region" required />
                    </div>
                </div>
                <div class="form-group">
                    <label class="form-label">City</label>
                    <div class="form-input">
                        <input ng-model="blade.currentEntity.city" required placeholder="Enter city" />
                    </div>
                </div>
                <div class="form-group">
                    <label class="form-label">Address</label>
                    <div class="form-input">
                        <input ng-model="blade.currentEntity.line1" placeholder="Enter address line 1" required />
                    </div>
                    <div class="form-input">
                        <input ng-model="blade.currentEntity.line2" placeholder="Enter address line 2" />
                    </div>
                </div>
                <div class="form-group">
                    <label class="form-label">Zip code</label>
                    <div class="form-input">
                        <input ng-model="blade.currentEntity.postalCode" required placeholder="Enter postal code" />
                    </div>
                </div>
                <div class="form-group">
                    <label class="form-label">Phone</label>
                    <div class="form-input">
                        <input ng-model="blade.currentEntity.daytimePhoneNumber" required placeholder="Enter phone number" type="tel" />
                    </div>
                </div>
            </form>
        </div>
    </div>
</div>